Asclepion of Epidaurus: the application of a historical perspective in medical education.

BACKGROUND: The Asclepion of Epidaurus is one of the first healing environments in the world. Descendants of Asclepius, specifically medical students, have been singularly deprived of any information concerning this legacy. This article illuminates the role of Asclepion of Epidaurus and examines the view of medical students upon the subject and the possible benefits of this knowledge in their medical education. METHODS: The participants were 105 senior-year students from the Athens Medical School, who attended a multi-media assisted lecture related to the structure and the role of the Asclepion of Epidaurus. Afterwards, they answered anonymously a questionnaire of 12 pairs of opposite adjectives in order to describe their view regarding the meaning of Asclepion. The method used in the evaluation of their answers was that of semantic differential. RESULTS: The attitude of the students towards the meaning of Asclepion was positive, showing interest and excitement about a powerful, though unfamiliar piece of knowledge. CONCLUSION: Today's novice doctors have welcomed the concept of Asclepion as essential knowledge for the service they will be called to fulfill. The potential benefits of the Asclepian ideals in medical education and ethos are thoroughly discussed.

For the Benefit of Students: Memory and Anatomical Learning at Bologna in the Fourteenth to Early Sixteenth Centuries.

The anatomical textbook in the late Middle Ages was one part of a greater pedagogical process that involved students' seeing, hearing, reading, and eventually knowing information about the human body. By examining the role of the anatomical textbook and accompanying bodily images in anatomical learning, this article illuminates the complexity and self-consciousness of anatomical education in the medieval university, as professors focused on ways to enhance student memory of the material. Traditionally, the history of anatomy has been heavily influenced by the anatomical Renaissance of the late-sixteenth century, highlighting a focus on innovative medical knowledge and the scientific method. However, if we engage a pedagogical lens when looking at these medieval authors, it becomes quickly obvious that the whole point of university medicine was not to explore unknown boundaries and discover new ideas of medicine, but rather to communicate the current and established body of knowledge to those not familiar with it.

Descifrando narrativas contemporáneas sobre la salud y la enfermedad: el proyecto Madrasa / Deciphering Contemporary Narratives on Health and Disease: The Madrasa Project

OBJETIVO: describir el desarrollo del proyecto Madrasa y sus resultados tras dos años de implementación. METODOLOGÍA: proyecto de innovación docente llevado a cabo con metodología de Investigación-Acción Participativa y la participación de alumnos de los grados de Enfermería, Medicina y Antropología Social y Cultural de la Universidad de Granada. Resultados principales: se realizaron 10 círculos narrativos, 2 elucidarios y 2 visitas dialogadas, contando con 19 expertos invitados. Se registraron 1203 participantes (785 alumnos) en las actividades presenciales y los círculos narrativos experimentaron 8.400 visitas desde las plataformas digitales, con una satisfacción media del 84 %. Conclusión principal: el proyecto Madrasa ha logrado instaurar una pedagogía innovadora, apoyada en la transformación digital, con enfoque multidisciplinar, que contribuye a incorporar a la enseñanza reglada de los futuros profesionales de la salud y la antropología, de una forma transversal, competencias para el desarrollo del pensamiento crítico en el análisis de la diversidad de narrativas que se producen en torno a la salud y la enfermedad en el mundo contemporáneo

OBJECTIVE: to describe the development of the Madrasa project and its results after two years of implementation. METHODOLOGY: teaching innovation project carried out with Participatory Action Research methodology and the participation of students from the Nursing, Medicine and Social and Cultural Anthropology degrees at the University of Granada. MAIN RESULTS: 10 narrative circles, 2 elucidations and 2 dialogued visits were carried out, with 19 invited experts. 1203 participants (785 students) were registered in the face-to-face activities and the narrative circles experienced 8,400 visits from digital platforms, with an average satisfaction of 84%. Main conclusion: the Madrasa project has managed to establish an innovative pedagogy, supported by digital transformation, with a multidisciplinary approach, which contributes to incorporating into the regulated education of future health and anthropology professionals, in a transversal way, competences for the development of critical thinking in the analysis of the diversity of narratives that occur around health and disease in the contemporary world

Revolución flexneriana y su influencia en la educación médica / Flexnerian revolution and its influence on medical education

La evolución de la educación médica en América tiene un momento clave en la historia, definido con el estudio de las escuelas de medicina de Estados Unidos y Canadá realizado por Abraham Flexner en 1910, el cual dividió en su momento a la educación médica en una etapa pre-flexneriana y post-flexneriana. Este estudio caracterizó al sistema educativo médico en Estados Unidos como un sistema deficiente, carente de regulación y sin estándares establecidos. La medicina, enseñada y ejercida con pocos principios científicos representaba un importante problema de salud y seguridad poblacional. Ante este panorama, la Asociación Americana de Medicina decide promover una evaluación de la mayoría de las escuelas de medicina con el fin de proponer cambios en el sistema educativo médico. Flexner, un teórico educativo, realiza el análisis curricular, de evaluación y prácticas ejercidas en 155 centros educativos. De su reporte se desprende la propuesta conocida como Revolución Flexneriana la cual hace tambalear el sistema educativo médico en Norteamérica en 1910. Enfatizando falta de estandarización, integración, investigación y deficiencia de la formación de médicos con identidad profesional, Flexner propuso cambios que en su momento llegaron a regir la enseñanza de los médicos en Norteamérica. Se realizó una revisión bibliográfica utilizando búsqueda manual en PubMed y Google Scholar para hacer descripcion de los aspectos históricos de la educación médica en Norteamérica, su influencia en Latinoamérica y la prevalencia actual de la integración curricular en muchas escuelas de medicina...(AU)

Tendencias histórico-pedagógicas del proceso de formación de valores en estudiantes de medicina cubanos a partir del triunfo revolucionario / Historical-pedagogical tendencies of the values training in Cuban medicine students from the revolutionary victory on

En el presente artículo se brinda un análisis histórico y pedagógico de la formación médica en Cuba a partir del triunfo revolucionario. Se identifican las tendencias pedagógicas por las que discurre dicha formación, lo que caracteriza el movimiento del proceso en cada etapa históricamente determinada por estos autores. Este análisis permitió revelar 3 etapas, a partir de los principales hitos en el proceso de formación en valores del médico después de la Reforma Universitaria de 1962 hasta 2018 en Cuba y se precisó en cada una de ellas la concepción del proceso formativo del profesional de la carrera de medicina, así como las limitaciones metodológicas y didácticas del valor responsabilidad en dicho proceso.

A historical and pedagogical analysis of the medical training in Cuba from the revolutionary victory on, is presented in this work. The pedagogical tendencies through which this training goes are identified, what characterizes the movement of the process in each historically determined stage by these authors. This analysis allowed to reveal 3 stages, from the main landmarks in the values training process after the University Reform of 1962 to 2018 in Cuba and it was stated in each of them the conception of the professional training process for the medicine career, as well as the methodological and didactic limitations of the value responsibility in this process.

The Fall and Rise of Mid-Century Student Health Activism: Political Repression, McCarthyism, and the Association of Internes and Medical Students (1947-1953).

Common narratives about the mid-century American medical profession's stunning rise forget a key element: political repression. During the 1940s and 1950s, the American Medical Association (AMA) and its allies sought to eliminate those who questioned American medicine's status quo, in particular opposition to national health insurance (NHI) and condoning of racism within its ranks. One casualty was the Association for Internes and Medical Students (AIMS), which into the 1940s, was the most prominent vehicle for medical student and trainee political organizing in the United Status. This article tells the story of its rapid demise in the era of McCarthyism at the hands of an AMA campaign to besmirch AIMS's name, and in the process, destroy it.

On being a pathologist: a pathway to pathology practice; the added value of supplemental vocational training and mentoring in college and medical school.

Traditionally, vocational training and liberal arts (and premedical) curricula have been separate education tracks. This personal profile describes a program that evolved from the partial fusion of vocational training and a premedical education track. My personal health issue, visual impairment, which presumably resulted as a complication of congenital toxoplasmosis, hampered my ability to read in grammar school and necessitated my placement in remedial reading classes until eighth grade. My father created an independent home-based vocational training program that ran in parallel to my traditional school education all the way through college. In this case study, I provide an overview of this hybrid education program, which we refer to as the Vocational Training/Medical College Curriculum of the Future (VTMC). This term implies that the education of a student from K-12 school through medical college is a continuum. I find it useful to conceptualize a single education continuum beginning with vocational training and ending with medical education, with a large overlap area in the middle. In this paper, I describe a set of my work experiences that leveraged and reinforced my didactic education experiences. Mentors who supported aspects of the VTMC program have included a college president, a US Congressman, a Nobel Laureate, and a Massachusetts General Hospital leader in academic pathology. Elements of this innovative VTMC program have been used in K-12 public schools and in nonmedical graduate school programs.

Los usos políticos del teatro. Sociabilidad científica y médica en la ciudad de Buenos Aires (1870 -1920) / The Political uses of theather. Scientific and medical sociability in the city of Bienos Aires at the end of century (1870 -1920)

Se estudian tres ceremonias científicas organizadas en distintos teatros de la ciudad de Buenos Aires por el Círculo Médico Argentino (CMA). Como parte de las prácticas de sociabilidad de esta institución, estas ceremonias, dedicadas a conmemorar episodios e individuos centrales en la frágil comunidad médica de la segunda mitad del siglo XIX, fueron uno de los recursos utilizados por el CMA para la transmisión de sentidos, valores y representaciones acerca de la práctica médica local a la sociedad civil y el poder político de su época. Esta estrategia de amplificación de los aspectos simbólicos y culturales de la práctica profesional y científica de la medicina fue utilizada por el CMA tanto para construir audiencias mayores, ganar visibilidad y demandar legitimidad para el conjunto de prácticas médicas, como para abrir una brecha de acceso al reconocimiento político en una ciudad con tendencia a mirar como extraños a médicos y hospitales hasta bien entrado el siglo XX. En especial, los tres casos estudiados permiten ilustrar las estrechas relaciones entre las ceremonias teatrales y la puesta en circulación de un programa experimental para las ciencias médicas de la ciudad de Buenos Aires

Three scientific ceremonies organized in different theaters of the city of Buenos Aires by the Argentine Medical Circle (CMA) are studied. As part of practices of sociability of this institution, these ceremonies dedicated to commemorate episodes and central individuals in the medical community in the second half of the nineteenth century were one of the resources used by the CMA for the transmission of meanings, values and representations about the local medical practice civil society and political power. This amplification strategy of symbolic and cultural aspects of professional and scientific practice of medicine was used by the CMA both to build larger audiences, gain visibility and claim legitimacy for all medical practices, such as to open a gap in access to political recognition in a city with a tendency to look like strangers to doctors and hospitals until well into the twentieth century. In particular, the three case studies to illustrate the close relationship between the theatrical ceremonies and the circulation of a pilot program for medical sciences in Buenos Aires city

[The cadaverous fever in Chile, death in the anatomical amphitheater]. / La infección cadavérica en Chile, muerte en el anfiteatro anatómico.

Cadaverous infection is a little-known nosological entity that affected the dissectors in the practice and teaching of anatomy, since working on the dissection of cadavers entails risks in relation to the occurrence of sharps injuries that produce infections and even death associated with the manipulation of them. The present investigation is motivated by a story about a student who was injured in the dissemination ward in 1937 at the Institute of Anatomy of the U. of Chile. Historical background is investigated associated to the death of students in the usual practice with cadavers through writings and stories since the beginning of the anatomical teaching in Chile since 1833, identifying the conditioning factors that modify the epidemiology of this condition according to medical advances. Therefore, it is concluded that the designation of a dissector, the use of disinfectants and gloves, as well as the advance in the use of cadaveric preservation products, drastically reduce the biological risk of acquiring an infection known as cadaverous in the permanent contact of the students with cadaverous material for dissection of teacher use.

La infección cadavérica en Chile, muerte en el anfiteatro anatómico / The cadaverous fever in Chile, death in the anatomical amphitheater

Resumen La infección cadavérica es una entidad nosológica poco conocida y que afectaba a los disectores en la práctica y enseñanza de la anatomía. La disección de cadáveres supone riesgos como la ocurrencia de heridas corto-punzantes causantes de infecciones e incluso la muerte asociadas a la manipulación de los mismos. La presente investigación nace por el relato sobre un alumno herido en el pabellón de disección en 1937 en el Instituto de Anatomía de la Universidad de Chile. Se indagaron los antecedentes históricos asociados al fallecimiento de alumnos en la práctica habitual con cadáveres, a través de escritos y relatos desde los inicios de la docencia anatómica en Chile, en 1833. Se relatan las condiciones que han modificado la epidemiología de esta afección, según los avances médicos. Por lo anterior, se concluye que la designación de un disector, el uso de productos desinfectantes y guantes, además del avance en el uso de productos de conservación cadavérica han disminuido drásticamente el riesgo biológico de adquirir alguna infección por el contacto con cadáveres para disección de uso docente.

Cadaverous infection is a little-known nosological entity that affected the dissectors in the practice and teaching of anatomy, since working on the dissection of cadavers entails risks in relation to the occurrence of sharps injuries that produce infections and even death associated with the manipulation of them. The present investigation is motivated by a story about a student who was injured in the dissemination ward in 1937 at the Institute of Anatomy of the U. of Chile. Historical background is investigated associated to the death of students in the usual practice with cadavers through writings and stories since the beginning of the anatomical teaching in Chile since 1833, identifying the conditioning factors that modify the epidemiology of this condition according to medical advances. Therefore, it is concluded that the designation of a dissector, the use of disinfectants and gloves, as well as the advance in the use of cadaveric preservation products, drastically reduce the biological risk of acquiring an infection known as cadaverous in the permanent contact of the students with cadaverous material for dissection of teacher use.

10-year review of Africa's first student surgical society - UCT Surgical Society.

The UCT Student Surgical Society is an undergraduate surgical society based at the University of Cape Town (UCT) which aims to promote surgical education amongst medical students early in their medical careers. Founded in 2006, this was Africa's first student surgical society and has been joined by other medical schools in Africa also establishing their own undergraduate student surgical societies. In this review of the first 10 years of the society, we describe its objectives, its evolution and its international role.

The impact after 50 years of a new medical education programme with a regional workforce mission.

BACKGROUND: Tasmania established its medical programme in 1965 to produce graduates to address medical workforce recruitment challenges. Many Tasmanian graduates work in Tasmania, but workforce problems continue. This paper reports the workforce outcomes of the first 42 graduating cohorts. METHODS: A database for all University of Tasmania medical graduates from the years 1970 to 2011 was developed by combining information from university, registration and local workforce survey databases. RESULTS: A total of 2012 doctors graduated from 1971 to 2011 and 1707 (85%) were registered, most commonly in general practice (45.8%), medicine (13%), anaesthetics (7.9%), surgery (7.5%), psychiatry (4.3%), emergency medicine (35, 3.5%), paediatrics (3.4%) and pathology (3.3%). While 41.9% worked in Tasmania, they comprised 35.6% of the local workforce and were clustered around the two larger cities. The proportion entering general practice has fallen since 1980s. DISCUSSION: The contribution of the Tasmanian medical programme is substantial but appears less than other regional medical schools. Relatively few work in smaller communities, particularly in specialties other than general practice. Lifestyle choices and the availability of training opportunities and career positions might be contributing factors. The medical school has established clinical schools in rural communities, promoted admission of rural applicants and increased rural clinical placement opportunities, with some early signs of success. CONCLUSION: The Tasmanian medical programme is important in this regional, island economy, but the rural and remote communities have not benefited as much as the two larger cities. Sustaining a regional workforce mission over time might require frequent adjustments to admissions and curriculum processes.

Jules and Augusta Dejerine, Pierre Marie, Joseph Babinski, Georges Guillain and their students during World War I.

World War I (1914-1918), however tragic, was nonetheless an "edifying school of nervous system experimental pathology" not only because of the various types of injuries, but also because their numbers were greater than any physician could have foreseen. The peripheral nervous system, the spine and the brain were all to benefit from the subsequent advances in clinical and anatomo-functional knowledge. Neurosurgeons took on nerve sutures, spinal injury exploration, and the localization and extraction of intracranial foreign bodies. Little by little, physical medicine and rehabilitation were established. A few of the most famous Parisian neurologists at the time-Jules and Augusta Dejerine, Pierre Marie, Joseph Babinski and Georges Guillain, who directed the military neurology centers-took up the physically and emotionally exhausting challenge of treating thousands of wounded soldiers. They not only cared for them, but also studied them scientifically, with the help of a small but devoted band of colleagues. The examples presented here reveal their courage and their efforts to make discoveries for which we remain grateful today.